TY - JOUR
T1 - Differentiating among Attempted, Completed, and Multiple Nonfatal Strangulation in Women Experiencing Intimate Partner Violence
AU - Messing, Jill
AU - Patch, Michelle
AU - Wilson, Janet Sullivan
AU - Kelen, Gabor D.
AU - Campbell, Jacquelyn
N1 - Funding Information:
The Oklahoma Lethality Assessment Study, a quasi-experimental field trial funded by the National Institute of Justice, was conducted between 2009 and 2013 to examine the effectiveness of the Lethality Assessment Program. The Lethality Assessment Program is a risk-informed collaborative intervention ( Messing & Campbell, 2016 ) that was developed by the Maryland Network Against Domestic Violence ( www.mnadv.org/lethality ), takes place at the scene of a police-involved IPV incident, and consists of two steps: 1) police officers use a risk assessment, the Lethality Screen ( Messing, Campbell, Wilson, Brown, & Patchell, 2017 ), to determine if an IPV survivor is at high risk of homicide, and 2) if so, the officer places the survivor in telephone contact with a collaborating advocacy organization. Women in intervention and comparison groups participated in structured telephone interviews at two time points approximately 7 months apart. This inquiry uses data from the first interview only, which was conducted as soon as possible after the police-involved IPV incident. The study received Institutional Review Board approval from Arizona State University, Johns Hopkins University, the University of Oklahoma Health Sciences Center, the Oklahoma State Department of Health, the Cherokee Nation, and the National Institute of Justice. Primary results were published in 2015, and indicate that the Lethality Assessment Program increased survivor protective actions and decreased IPV victimization ( Messing et al., 2015 ).
Funding Information:
Funding Statement: This research study was funded by the National Institute of Justice #2008-WG-BX-0002.
Publisher Copyright:
© 2017 Jacobs Institute of Women's Health
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Purpose Because identification of intimate partner violence (IPV) in health care settings is low and strangulation increases lethality risk among women experiencing IPV, we examined the prevalence and correlates of nonfatal strangulation among 1,008 women survivors of IPV. Methods Trained researchers conducted semistructured interviews with women survivors of IPV referred by police. Multinomial logistic regression examined differential correlates of attempted, completed, and multiple strangulation. Results Interviews were conducted with 71.14% of eligible women contacted by researchers. A high proportion (79.66%) of the women interviewed experienced attempted (11.70%), completed (30.16%), or multiple (37.80%) strangulation. Each form of strangulation was independently significantly associated with sexual violence when compared with no strangulation. African American women were at increased risk of attempted (adjusted relative risk ratio [ARR], 2.02; p <.05), completed (ARR, 1.79; p <.05), and multiple strangulation (ARR, 2.62; p <.001). Compared with no strangulation, multiple strangulation was associated with more IPV injury and risk factors for homicide, including loss of consciousness (ARR, 2.95; p <.05) and miscarriage (ARR, 5.08; p <.05). Women who had lost consciousness owing to strangulation were more likely to seek medical care than those who had been strangled but had not lost consciousness (p <.01). Conclusions Strangulation is a prevalent form of IPV that presents significant health risks to women. Women's health practitioners are optimally positioned to identify subtle signs and symptoms of strangulation, help women to understand the delayed sequelae and potential future fatality associated with strangulation, and connect them with appropriate resources to reduce the risk of morbidity and mortality.
AB - Purpose Because identification of intimate partner violence (IPV) in health care settings is low and strangulation increases lethality risk among women experiencing IPV, we examined the prevalence and correlates of nonfatal strangulation among 1,008 women survivors of IPV. Methods Trained researchers conducted semistructured interviews with women survivors of IPV referred by police. Multinomial logistic regression examined differential correlates of attempted, completed, and multiple strangulation. Results Interviews were conducted with 71.14% of eligible women contacted by researchers. A high proportion (79.66%) of the women interviewed experienced attempted (11.70%), completed (30.16%), or multiple (37.80%) strangulation. Each form of strangulation was independently significantly associated with sexual violence when compared with no strangulation. African American women were at increased risk of attempted (adjusted relative risk ratio [ARR], 2.02; p <.05), completed (ARR, 1.79; p <.05), and multiple strangulation (ARR, 2.62; p <.001). Compared with no strangulation, multiple strangulation was associated with more IPV injury and risk factors for homicide, including loss of consciousness (ARR, 2.95; p <.05) and miscarriage (ARR, 5.08; p <.05). Women who had lost consciousness owing to strangulation were more likely to seek medical care than those who had been strangled but had not lost consciousness (p <.01). Conclusions Strangulation is a prevalent form of IPV that presents significant health risks to women. Women's health practitioners are optimally positioned to identify subtle signs and symptoms of strangulation, help women to understand the delayed sequelae and potential future fatality associated with strangulation, and connect them with appropriate resources to reduce the risk of morbidity and mortality.
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U2 - 10.1016/j.whi.2017.10.002
DO - 10.1016/j.whi.2017.10.002
M3 - Article
C2 - 29153725
AN - SCOPUS:85034430508
SN - 1049-3867
VL - 28
SP - 104
EP - 111
JO - Women's Health Issues
JF - Women's Health Issues
IS - 1
ER -